Guidelines for Formula Selection

Selection of an optimal infant, pediatric or adult enteral formula for use in a pediatric patient depends on both patient factors and formula factors as follows:

Patient Factors Formula Factors
Age
Diagnosis
Associated nutritional problems
Nutritional requirements
Gastrointestinal function		 Osmolality
Renal solute load
Caloric density and viscosity
Nutrient composition: type & amount of CHO, Fat and protein
Product availability and cost

Infant, Pediatric and Adult Enteral Formulas - Refer to:

Modifying Formula Caloric and Nutrient Density

Children who are critically or chronically ill may be unable to take adequate formula volume to meet their nutritional needs. Infant and pediatric formulas may be prepared differently to provide a greater caloric or nutrient density by any one or a combination of the following methods:

  • Concentration - increasing the amount of formula base or decreasing the amount of free water added when mixing the formula.
  • Supplementation - Adding a macronutrient module in order to increase caloric density without increasing all other nutrient sources. This may be accomplished through the addition of:
    1. Carbohydrate source: Polycose (Ross Laboratories), Moducal (Mead-Johnson)
    2. Fat source: Microlipid (Mead-Johnson)
    3. Protein source: ProMod (Ross Laboratories)
    4. Addition of powdered formula (adds all macro and micronutrients)
      (The addition of 1 tsp of Polycose and 2 cc of Microlipid per 4 oz of a formula base will increase the caloric density by 3 kcal/oz)